Busier-than-ever NHS ‘buckling under controls on spending’

The NHS in England is “buckling” under a “mismatch” between soaring demand for care and levels of funding, a think tank has warned.

The King’s Fund said the number of admissions to hospital were rising steeply and were outstripping increases in the health service budget.

Hospital admissions have increased 3.6% a year since 2003/4. A&E attendances, referrals to outpatient services and diagnostic tests have also increased, it added. But since 2010, this increased activity has coincided with a prolonged funding squeeze, a new report by the think tank states.

Between 2010/11 and 2014/15, funding increases “slowed significantly”, averaging 1.2% each year, compared with average increases of 4.8% a year between 2003/04 and 2010/11, the authors said. As a result of this mismatch between funding and activity, plans for the health service in the coming years could be in jeopardy, the report warns.

The NHS Five Year Forward View sets out a plan for meeting the projected gap between funding and demand - but the authors said: “Failure to moderate the rise in demand for hospital care... highlights the challenges in delivering the Forward View.”

It also warned that the “squeeze on spending” is set to tighten further over the coming years, with 1.1% growth in 2017/18, no growth in real terms funding in 2018/19 and only 0.4% in 2019/20.

Chris Ham, chief executive of The King’s Fund, said: “The NHS is treating more patients than ever before, which is a tribute to the hard work and commitment of its staff.

“However, our analysis provides more evidence that the health system is buckling under the strain of trying to meet rising demand and maintain standards of care within constrained resources.

“With the gap between funding and hospital activity set to grow over the next few years, the NHS needs to do everything it can to moderate demand for hospital care.

“We know that some of this demand can be avoided if alternative services are available - the challenge is to provide the right care in the right place at the right time and to ensure hospitals are only used when necessary and appropriate.

“This means increasing investment in community services to provide more care closer to people’s homes and focusing on prevention to reduce the need for treatment in the first place.”